Rheumatoid Arthritis

The multimillion dollar question for inflammatory arthritis prescriptions is: which drug should I use next?

Drs. Jack Cush & Arthur Kavanaugh, two of rheumatology’s most trusted voices, provide a breakdown of the latest breakthroughs and hottest topics in rheumatology from the 2025 ACR Convergence meeting in Chicago.

Here's the last installment of our "ACR Best" abstracts as chosen by the RheumNow faculty.  Most of these were from the final, day 4, but a few were noteworthy holdovers from day 3. Enjoy!

Promising novel mechanisms of action always create excitement, but the immune checkpoint PD-1 has cemented itself in the news far more than most. This fame is primarily from therapeutic inhibition in cancer and rheumatological inflammatory sequelae that emerge, but invoking the inverse and using PD-1 agonism to treat classical autoimmunity has subsequently been making its own mark. Given the evident plausibility, how do we feel about invoking

At ACR Convergence 2025, abstract 1039 entitled, “Global Cost-Effectiveness and Equity in CAR-T Cell Therapy for Rheumatoid Arthritis” adds a critical dimension to the growing enthusiasm around cellular therapies in autoimmune disease.

For the last several years, conversations about JAK inhibitors have often started and ended with safety. The shadow cast by ORAL Surveillance has made clinicians more cautious and regulators more restrictive. Yet in practice, many of us continue to reach for upadacitinib when we face challenges in treatment, from rheumatoid arthritis to axial spondyloarthritis. 

Methotrexate (MTX) remains the cornerstone of rheumatoid arthritis (RA) treatment, yet it remains unclear as to how to predict who will respond to it. Two studies presented at ACR (Abstracts 2639 and 2643) suggest the answer may be hiding in the gut.

At ACR 2025, the session “27M02: Nutrition for Rheumatic Disease: Where Aging Biology, Sarcopenia, and Diet Intersect” invited the audience to view rheumatic disease through the lens of biological aging and to consider how nutrition and exercise can serve as integrative lifestyle interventions.

Two new studies presented this year tackle a key question: can our initial treatment choices influence who ends up in the difficult-to-treat category?

Here are 3 abstracts that caught my eye on Day 2 at ACR25. Notably these have takeaway messages that should support your current practices.

CAR T-cells have been a revolutionary development in rheumatology. We have seen a population of patients with severe refractory autoimmune conditions almost overnight presented with the prospect of not just improvement, but of a cure.

As the population ages globally, rheumatologists are caring for an increasingly older patient population more than ever before. In RA alone, nearly 40 percent of patients are now aged 65 years or older. Yet the evidence guiding our treatment decisions continues to come from studies that rarely include them, giving rise to a fundamental question: do we really know how best to treat older adults with rheumatic diseases?

New research presented at ACR Convergence 2025 highlights how the Rheumatology Informatics System for Effectiveness (RISE) registry—the nation’s largest collection of electronic health record data from rheumatology practices—is driving transformative improvements in quality, safety, and patient outcomes across rheumatic and musculoskeletal diseases.

The GLP-1 story has been hard to miss this year, and at ACR Convergence, it’s clear that these drugs are starting to make real waves in rheumatology. Across multiple abstracts, investigators have used a large real-world dataset, the TriNetX network, to explore how GLP-1 receptor agonists (GLP-1RAs) might influence cardiovascular, renal and immune-mediated outcomes in our patients.

ACR 2025 began today in Chicago with throngs of rheumatologists, fellows, ARP members, APPs and pharma folk taking to the meeting halls and rooms for tons of novel content.